Inside Augusta

Able-bodied adults should work to receive Medicaid benefits

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Lawmakers on the Health and Human Services Committee yesterday held a public hearing on a bill, sponsored by Rep. Beth O’Connor, that would implement the waiver approved by the federal government allowing Maine to impose work requirements within its Medicaid program.

The bill, LD 891, would allow the state to require able-bodied Medicaid recipients to work, volunteer or go to school for 20 hours a week, pay up to $40 in monthly premiums and pay $10 for emergency room visits in order to maintain Medicaid coverage.

In December 2018, before former Gov. Paul LePage left office, the federal government approved Maine’s Section 1115 demonstration waiver to require that recipients of Medicaid work to receive benefits. After taking office, Gov. Janet Mills refused to implement the waiver, calling work requirements “problematic” and saying her goal was to invest in workforce development instead of imposing mandates on those struggling to make ends meet.

Fast forward a few months and we have a $8.041 billion budget proposal filled with new mandates but lacking any workforce development plan. It appears the governor is content with allowing able-bodied adults to receive subsidized health coverage from their neighbors without asking them to contribute to society like the rest of us. According to The Foundation for Government Accountability, Census Bureau data show only 16 percent of able-bodied Medicaid recipients are full-time, year-round workers and 52 percent do not work at all.

Calling these work requirements “problematic” is laughable considering they are far from rigorous — individuals would be required to work 20 hours a week, pay monthly premiums of up to $40 a month, and contribute $10 if they go to an emergency room for a non-emergency issue. Those who get up and go to work every day to provide for their families pay far more without taking a penny in government assistance.

Work requirements provide a pathway from dependency to prosperity by empowering individuals to work their way off of government assistance programs. The waiver approved by the Center for Medicaid Services details excluded populations such as pregnant women and people who are physically or mentally incapable of working 20 hours or more per week. Thus, individuals who truly cannot fulfill the requirements will not be penalized.

New Hampshire recently implemented work requirements for Medicaid recipients, necessitating that they work at least 100 hours a month (even more rigorous than Maine’s request). Qualifying activities include going to school, holding a job, or participating in community service. These rules have been approved in eight other states and are pending in seven.

While it is too early to tease out the effects of this change in New Hampshire’s Medicaid program, Arkansas has seen positive results. Last year, 18,164 people left the program in Arkansas because they failed to meet the work requirements. Liberals cite this same figure as an example of the failure of work requirements, having forced nearly 20,000 Arkansans to forego health coverage.

However, what they will not tell you is that the vast majority of individuals who were subjected to these work requirements did not fail to meet them. In fact, 71 percent or more of Medicaid recipients in Arkansas have consistently met the minimum work requirements to continue receiving benefits. To be clear, the efficacy of government assistance programs should not be measured by how many individuals they enroll, but by how many individuals they actually help transition back to work after falling on hard times.

Source: Arkansas Department of Human Services

Arkansas’ work requirements have been overwhelmingly positive for reducing government dependency and reserving public resources for the truly needy. The Medicaid program was originally intended to serve low-income children, pregnant women and the disabled. It doesn’t exist to subsidize health coverage for able-bodied adults who choose not to work. According to the Kaiser Family Foundation, Maine’s Medicaid and CHIP enrollment in December 2018 stood at approximately 257,000, and that was before we sought to enroll an estimated 70,000 childless, able-bodied adults through Medicaid expansion.

Maine is at a crossroads. We could prioritize the Medicaid program for the truly needy, or allow able-bodied adults to become dependent on it. As noted in an analysis released last week, more than 2,400 Mainers with disabilities continue to languish on wait lists as we expand Medicaid coverage to able-bodied adults. By allowing this population to become dependent on Medicaid, funds are being drained that could otherwise go to those who need our help.

Able-bodied adults cannot live up to their full potential if they become dependent upon government and do not work. Maine should implement the work requirements waiver to ensure our tax dollars are prioritized to serve our most vulnerable neighbors.

About Adam Crepeau

Adam Crepeau serves as a policy analyst at The Maine Heritage Policy Center. He can be reached at acrepeau@mainepolicy.org.

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